Due to the scale and spread of transmission, the novel coronavirus (COVID-19) outbreak was declared a global pandemic on 11 March 2020.Current medical evidence shows that the main symptoms of COVID-19 include coughing, fever and, in severe cases, shortness of breath, although some people may carry the virus without being symptomatic. While 80 per cent of the COVID cases globally are considered to be mild, the elderly, as well as people with compromised immune systems and pre-existing health conditions, such as diabetes or heart disease, are considered to be at higher risk. As it is a new virus, the lack of immunity in the population (and the absence as yet of an effective vaccine) means that COVID-19 is spreading quickly around the globe.
Afghanistan is likely to be significantly affected due to its weak health system and limited capacity to deal with major disease outbreaks. Afghanistan’s close proximity to the Islamic Republic of Iran – a global hotspot for the virus – puts the country at heightened risk, with tens of thousands of people and commercial movements across the border from Iran each day. High internal displacement, low coverage of vaccination required for stronger immune systems and augmented ability to fight viral and bacterial infections), in combination with weak health, water and sanitation infrastructure, only worsen the situation.
As of 23 March, there were 42 confirmed COVID-19 cases in Afghanistan across 12 provinces, including Kabul. The first death from COVID-19 was confirmed on 22 March in Balkh Province involving a man with no travel history outside the country. Most of those confirmed with the virus so far do have a prior travel history, mostly to Iran. One person (the first diagnosed) has recovered and been released from hospital. To date, testing has been small scale which may account for the relatively low number of confirmed cases relative to the high number of border crossings from Iran.
No reliable COVID-19 modelling for a country with Afghanistan’s unique characteristics and vulnerabilities currently exists but WHO is working with experts to predict the likely spread. It is considered almost certain that the virus will spread to other provinces, beyond those already affected with a significant impact on the country’s estimated population of almost 38 million people (plus an additional two million Kuchi). Laboratory testing capacity is currently being expanded. While Afghanistan has recently received deliveries of diagnostic kits from UAE and China, diagnostic testing is still stretched given the increasing demand.
In response to the outbreak, the Government of Afghanistan has developed a master response plan for the health sector and has established a High-Level Emergency Coordination Committee in the area of health with various technical working groups (Surveillance and Early Detection; Coordination and Resource Mobilisation; Health Care Provision; Health Promotion and Risk communication; Infection prevention and protection); and efforts are ongoing to establish sub-national coordination structures particularly in Hirat province which has the highest number of confirmed cases to date. The Government has also decided to close all schools until 30 April and is considering a range of other restrictions on public gatherings, transportation and related actions.
As of 24-March, most major international border crossings are closed excepting the Iranian frontier which remains open. Pakistan’s borders are closed to people crossing but sporadic openings have permitted a small number of commercial vehicles to cross. Sustained movements of commercial and humanitarian goods across the Pakistan border are essential to markets in Afghanistan and the humanitarian response. Point of Entry screening was initiated in late January and is presently ongoing in eight locations throughout the country.
To support Government efforts to contain the disease and prevent further spread, the ICCT has developed this COVID-19 Multi-Sector Country Plan that outlines the strategic response approach to the outbreak for the next three months (April-June 2020). This document is intended to complement wider plans by the Ministry of Public Health/ WHO and all elements of these plans are fully aligned.